Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cedric R Willis, PA-C

Individual provider Physician Assistant · NPI 1801196589

Cedric R Willis, PA-C is a Physician Assistant in Shreveport, Louisiana. Qualified in 2010, 16 years ago. Practices with Gastrointestinal Specialists Amc, a 33-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
16
Licensed in
LA
In the registry since
2010
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

8001 Youree Dr Ste 540
Shreveport, LA 71115-2343
Phone: (318) 631-9121
Fax: (318) 631-9126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.200392 (LA)

Record details

NPI number1801196589
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 27, 2010
Last updated in NPPESAugust 12, 2022
Certification dateAugust 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Gastrointestinal Specialists Amc — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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